Supplementary use of the XP-endo Finisher on postoperative pain in posterior teeth with periapical lesions: a randomized clinical trial.

OBJECTIVE: This study evaluated the effect of the supplementary use of the XP-endo Finisher on postoperative endodontic pain. METHODS: This study was a randomized clinical trial with a parallel design. Ninety-two posterior teeth with necrotic pulps and apical periodontitis were instrumented with a single file (Reciproc) in a reciprocating movement followed or not (control) by additional instrumentation with XP-endo Finisher. Postoperative pain was assessed 24 h, 48 h, 72 h, and 7 days after the endodontic treatment (single session) using a universal pain assessment tool. The pain level was scored as absent, mild, moderate, or severe. The occurrence of sealer extrusion and flare-up was also recorded. Data on postoperative pain were analyzed through chi-square analysis, and the odds ratio was adjusted using a logistic regression model (α = 0.05). RESULTS: Similar levels and risks of postoperative pain were observed for both interventions, regardless of the assessment time. Approximately half of the participants presented any postoperative pain in the first 24 h after the endodontic treatment, and this occurrence reduced by less than 20% after 72 h. The extrusion of root filling material was observed in 36% of cases, and no participant presented flared-up. CONCLUSIONS: The supplementary use of the XP-endo Finisher file did not affect the incidence or level of postoperative pain reported after the endodontic treatment of posterior teeth with periapical lesions. CLINICAL RELEVANCE: The supplementary use of the XP-endo Finisher did not affect postoperative pain following the endodontic treatment of posterior teeth using a single-file reciprocating system. CLINICAL TRIAL REGISTRATION: The study protocol was registered in the Brazilian Clinical Trials Registry under identification number RBR-76w7cj (June 19, 2018).

Impact XP-endo finisher on the 1-year follow-up success of posterior root canal treatments: a randomized clinical trial.

OBJECTIVE: To evaluate the clinical relevance of using the XP-endo Finisher as a supplementary tool to improve the success of root canal treatment of posterior teeth with apical periodontitis, as assessed by 1-year follow-up. METHODS: A randomized clinical trial was conducted with 92 posterior teeth with apical periodontitis. Root canal treatment was performed using a single reciprocating file, with or without the supplementary use of the XP-endo Finisher. The status of apical periodontitis was assessed using the periapical index (PAI) at baseline and 1 year follow-up. Changes on PAI indicated that the lesions were healed, healing, or not healed. Successful treatments were defined as healed or healing lesions without clinical symptoms. Chi-square analysis and logistic regression were used for data analysis (α = 0.05). RESULTS: There was no significant difference in the distribution of healing status between the XP-endo Finisher group and the control group (p = 0.690). The success rates were also similar, with 81% in the XP-endo Finisher group and 78% in the control group. However, gender had a significant impact on success rates, with higher rates observed in females. CONCLUSIONS: The use of the XP-endo Finisher file as a supplementary tool did not affect the success rate of root canal treatment in posterior teeth with apical periodontitis. The findings indicate that the XP-endo Finisher file has limited clinical relevance in improving treatment outcomes for root canal treatment in posterior teeth with apical periodontitis. CLINICAL TRIAL REGISTRATION: The study protocol was registered in the Brazilian Clinical Trials Registry under identification number RBR-76w7cj (June 19, 2018).

Effects of adhesive used as modeling liquid on the stability of the color and opacity of composites.

OBJECTIVE: This study evaluated the effects of adhesive type used as modeling liquid on the stability of the color and opacity of composites submitted to thermal cycling in staining solutions followed by a bleaching procedure. METHODS: Thirty cylinder-shaped composite specimens (10 mm diameter × 1.5 mm thickness) were built using or not using (control) an adhesive (Adper Universal or Scotchbond Multipurpose) as the modeling liquid. After polishing procedures, the color and opacity were measured, and the specimens were submitted to 200 thermal cycles with 10 s of dwell time in baths of grape juice at 5°C, water at 37°C, and coffee at 55°C. Changes in opacity and color caused by the staining solutions were measured. Then, the specimens were bleached with 35% hydrogen peroxide for 45 minutes followed by color/opacity measurements. Data were analyzed by ANOVA and Tukey's test (α = 0.05). RESULTS: The use of modeling liquids did not affect the initial color and opacity of composite. Reduced changes to color (E00 = 3.44) and opacity (+2.67%) were observed for specimens modeled using Adper Universal. Bleaching procedures reduced the color (E00 = 1.9-3.8) and opacity (-2.3 to 3.1%) alterations caused by staining solutions but were unable to restore the values observed at baseline. CONCLUSION: The use of universal adhesive as modeling liquid significantly reduced the color and opacity changes caused by staining solutions, and the bleaching procedure partially re-established the opacity and color of the composites. CLINICAL SIGNIFICANCE: This study evaluates whether using adhesive systems for modeling a composite affects the color and opacity changes caused by staining solutions followed by a bleaching procedure. The findings suggest that the use of a universal adhesive as modeling liquid can reduce the alterations in optical properties caused by staining solutions, and the application of high-concentrated hydrogen peroxide over the composite reduce the color changes without fully recover the initial color.